Smokeless tobacco consumption in a multi-ethnic community in Pakistan: a cross-sectional study

Smokeless tobacco is commonly used in south Asia. In addition to causing oral and pharyngeal cancers, its harmful effects are comparable to smoking tobacco. A cross-sectional survey with systematic sampling was conducted in 2010-2011 to investigate smokeless tobacco use in a multi-ethnic, semi-urban population in Islamabad, Pakistan [n = 2030]. The prevalence of smokeless tobacco use was 16.0% [21.6% among males and 8.8% among females]; 51.7% of smokeless tobacco users were also cigarette smokers. The rate of smokeless tobacco use was comparatively high among Pakhtun males [38.2%] and Sindhi females [22.4%]. The associations between smokeless tobacco use and ethnicity, age group, income level and cigarette smoking were statistically significant among male smokeless tobacco users. Of the sample 41.4% [840/2030] had inadequate knowledge about the health problems associated with smokeless tobacco. Appropriate interventions are needed to raise awareness of the health risks and to prevent smokeless tobacco use

Complications and outcome with epidurals for labour: Analysis of seven years experience

To audit the incidence of obstetric epidural complications and its outcome at Fatima Memorial Hospital, Lahore. All parturients who received epidurals for painless deliveries in the labour room of Fatima Memorial Hospital from 1999 to 2005 were included in this audit. All parturients received bolus of 500-1000m1 of Ringers lactate or 0.9% Normal saline prior to insertion of epidural catheter. Information regarding parturient's name, age, gravida [primi or multi], effectiveness of epidural or any complication was noted by anaesthetist on register kept in the anaesthesia office. Out of 25916 deliveries during seven years, 2610 [10.07%] parturients received epidural for painless delivery. Those who received epidurals, 437 developed one or more complications. The overall incidence of complications was 19.57%.Consultants gave epidural to 2004 parturients [76.90%] and residents gave to 602 parturients [23.10%]. The most common complication or complaint was shivering, 166 parturient [6.36%]. Next common was hypotension, 162 parturients [6.20%]. Inadequate analgesia and missed segment noted in 99 [3.79%] parturients. Post delivery urinary retention was problem in 25 [0.95%]. Dural puncture occurred in 15 [0.57%] and three [0.11%] received blood patch for control of persistent post dural puncture headache. In three parturients procedure was abandoned. Other complication like Intravascular injection noted in two [0.07%], Catheter blockade in three [0.11%], Reinsertion of catheter required in five [0.19%] and High spinal noted in three [0.11%] parturients. One parturient had total spinal and intubated, Eight [0.30%] parturients complained backaches. Out of 2610, parturients who received epidurals 237 [9.09%] underwent Caesarian sections, 185 [7.09%] deliveries were assisted by Vacuum and 150 [5.57%] by outlet forceps. Every sixth parturient [16.747%] is susceptible to get some form of complications when epidural analgesia is offered for pain relief but these complications can be detected early and managed if monitoring facilities available

impact of acute myocardial infarction in Abu Dhabi

A retrospective study was undertaken of a11 patients admitted with myocardial infarction to the Abu Dhabi Central Hospital, over a three-and-a-half year period, July 1978 to December 1981. In the 319 patients, there were 45 deaths, whilst 274 [86 per cent] survived their infarct. The average yearly mortality before the opening of the Coronary Care Unit [CCU] at the hospital [July 1979] was 16.1 per cent, and this was noted to drop sharply to 10.7 per. cent when patients were admitted directly to the CCU The predisposing and risk factors attending myocardial infarction in our group of patients is examined